Nursing Elites

1. When a client is comatose and has advance directives stating a desire to avoid life-sustaining measures, but the family wants these measures, what action should the nurse take?

• A. Arrange for an ethics committee meeting to address the family's concerns.
• B. Support the family's decision and initiate life-sustaining measures.
• C. Complete an incident report.
• D. Encourage the family to contact an attorney.

Correct answer: A

Rationale: In this scenario, the nurse should prioritize the client's wishes as outlined in the advance directives. By arranging for an ethics committee meeting, the nurse can facilitate discussions between the family and healthcare team to ensure that the client's wishes are respected while addressing the concerns of the family. This approach promotes ethical decision-making and collaborative communication among all involved parties, ultimately aiming to provide the best possible care for the client while considering their autonomy and preferences.

2. Which hormone is secreted by the Islets of Langerhans?

• A. Progesterone
• B. Testosterone
• C. Insulin
• D. Hemoglobin

Correct answer: C

Rationale: Insulin is the correct answer. It is the hormone secreted by the Islets of Langerhans in the pancreas. These specialized cells regulate blood sugar levels by releasing insulin in response to high blood glucose levels. Insulin aids in glucose absorption by cells, lowering blood sugar levels. Progesterone, testosterone, and hemoglobin are not secreted by the Islets of Langerhans and do not play a role in blood sugar regulation.

3. Which of the following is the correct meaning of CBR?

• A. Cardiac Board Room
• B. Complete Bathroom
• C. Complete Bed Rest
• D. Complete Board Room

Correct answer: C

Rationale: In medical terminology, 'CBR' stands for Complete Bed Rest. This term indicates the necessity for a patient to remain in bed without engaging in any physical activities beyond what is essential for daily living, to aid in the recovery process or to prevent further health complications. Choices A, B, and D are incorrect as they do not reflect the medical meaning of CBR.

4. A healthcare professional in an emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the healthcare professional take first?

• A. Obtain a baseline ECG.
• B. Obtain a blood specimen for ABG analysis.
• C. Insert an 18-gauge IV catheter.
• D. Administer 100% humidified oxygen.

Correct answer: D

Rationale: In a client experiencing drooling and hoarseness following a burn injury, airway compromise is a critical concern. Administering 100% humidified oxygen is the priority to ensure adequate oxygenation. This intervention takes precedence over obtaining baseline ECG, obtaining blood specimens, or inserting an IV catheter, as airway management and oxygenation are fundamental in the initial assessment and management of a client with potential airway compromise.

5. A healthcare provider reaches to answer the telephone on a busy pediatric unit, momentarily turning away from a 3-month-old infant she has been weighing. The infant falls off the scale, suffering a skull fracture. The healthcare provider could be charged with:

• A. Defamation
• B. Assault
• C. Battery
• D. Malpractice

Correct answer: D

Rationale: The scenario described involves a breach of duty by the healthcare provider to properly supervise the infant, resulting in harm. This failure to meet the standard of care falls under the category of malpractice, which refers to professional negligence or misconduct. Malpractice specifically applies to situations where a healthcare provider's actions or omissions deviate from the accepted standard of care, causing harm to a patient. In this case, the nurse's lack of supervision leading to the infant falling off the scale and sustaining a skull fracture would be considered malpractice.

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